GESTÃO DO CUIDADO AO COMPORTAMENTO SUICIDA NA ATENÇÃO PRIMÁRIA À SAÚDE
DOI:
https://doi.org/10.31011/reaid-2023-v.97-n.(esp)-art.1642Palavras-chave:
Ideação Suicida, Tentativa de Suicídio, Suicídio, Atenção Primária à Saúde., Assistência Integral à SaúdeResumo
Objetivo: analisar a gestão do cuidado ao comportamento suicida na atenção primária à saúde. Método: trata-se de uma revisão integrativa da literatura, realizada nas bases CINAHL, Scopus e Web of Science; e bibliotecas virtuais SciELO e Biblioteca Virtual de Saúde. Resultados: Analisou-se 33 publicações cujas informações foram sintetizadas em quadros e discutiu-se acerca da gestão do cuidado em saúde nas dimensões: individual, familiar, profissional, organizacional e sistêmica conforme referencial de Oliveira Cecílio. Considerações finais: Evidenciou-se diversas estratégias de gestão do cuidado ao comportamento suicida, no entanto, além dos desafios inerentes ao acesso e à continuidade do cuidado, a desarticulação da rede e a falta de treinamento dos profissionais de saúde impactam no planejamento e resolutividade do cuidado. Salienta-se a importância de investir na política de saúde mental de maneira a contemplar espaços para acolhimento e promoção da integralidade do cuidado, bem como, promover educação permanente e continuada aos profissionais.
Palavras-chave: Ideação Suicida; Tentativa de Suicídio; Suicídio; Assistência Integral à Saúde; Atenção Primária à Saúde.
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Referências
Grabois V. Gestão do cuidado. In: Gondim R, Grabois V, Mendes Júnior, WV, organizadores. Qualificação de Gestores do SUS. 2. ed. Rio de Janeiro: Fiocruz/ENSP/EAD; 2011. p. 153-190.
Merhy EE, Feuerwerker LCM, Santos MLM, Bertussi DC, Baduy, RS. Rede Básica, campo de forças e micropolítica: implicações para a gestão e cuidado em saúde. Saúde Debate. [Internet]. 2019 [cited 01 jun 2021];43 (esp):70-83. Available from: https://scielosp.org/article/sdeb/2019.v43nspe6/70-83/
Brasil. Agenda de Ações Estratégicas para a Vigilância e Prevenção do Suicídio e Promoção da Saúde no Brasil 2017 a 2020. Brasília: Ministério da Saúde, 2017. Disponível em: http://www.saude.gov.br/images/pdf/2017/setembro/21/17-0522-cartilha---Agenda-Estrategica-publicada.pdf
Pan American Health Organization. Prevention of suicidal behavior. Dialogues in Clinical Neuroscience [Internet]. Washington; 2016. [cited 26 mai 2020]. Disponível em: https://iris.paho.org/handle/10665.2/31166
Stene-Larsen K, Reneflot A. Contact with primary and mental health care prior to suicide: A systematic review of the literature from 2000 to 2017. Scand J Public Health. [Internet]. 2019 [cited 01 jun 2021]; 47(1):9-17. Available from: https://doi.org/10.1177/1403494817746274
Walby FA, Myhre MO, Kildahl AT. Contact with mental health services prior to suicide: A systematic review and meta-analysis. Psychiatr Serv. [Internet]. 2018 [cited 01 jun 2021]; 69(7):751-59. Available from: https://doi.org/10.1176/appi.ps.201700475
World Health Organization. Suicide worldwide in 2019: Global Health Estimates. [Internet]. Geneva: 2021. Available from: https://www.who.int/publications/i/item/9789240026643
American Psychological Association. Suicide Prevention. American Psychological Association, 2017. Available from: https://www.apa.org/advocacy/suicide-prevention
Gunnell D, Appleby L, Arensman E, Hawton K, John A, Kapur N, Khan M et al. Suicide risk and prevention during the COVID-19 pandemic. Lancet Psychiatry. [Internet]. 2020 [cited 17 out 2022]; 7(6):468-71. Available from: https://doi.org/10.1016/S2215-0366(20)30171-1
Sher L. The impact of the COVID-19 pandemic on suicide rates. QJM. [Internet]. 2020 [cited 17 out 2021]; 113(10):707-12. Available from: https://pubmed.ncbi.nlm.nih.gov/32539153/
Shiozawa P, Uchida RR. An updated systematic review on the coronavirus pandemic: Lessons for psychiatry. Braz J Psychiatry. [Internet]. 2020 [cited 17 out 2021]; 42(3):330-331. Available from: https://doi.org/10.1590/1516-4446-2020-0975
Whittemore R, Chao A, Jang M, Minges KE, Park C. Methods for knowledge synthesis: An overview. Heart Lung. [Internet]. 2014 [cited 17 out 2021]; 43(5):453-61. Available from: https://doi.org/10.1016/j.hrtlng.2014.05.014
The Joanna Briggs Institute. Joanna Briggs Institute Reviewers’ Manual: 2014 edition. Br J Psychiatry. Austrália; 2014. 196 p.
World Health Organization. Preventing suicide: A global imperative [Internet]. Geneva; 2014. Available from: https://www.who.int/mental_health/suicide-prevention/world_report_2014/en/
Souza MT, Silva MD, Carvalho R. Integrative review: what is it? How to do it? Einstein. [Internet]. 2010 [cited 11 jan 2020]; 8(1):102-6. Available from: https://doi.org/10.1590/s1679-45082010rw1134
Oliveira Cecilio LC. Apontamentos teórico-conceituais sobre processos avaliativos considerando as múltiplas dimensões da gestão do cuidado em saúde. Interface (Botucatu). [Internet]. 2011 [cited 11 jan 2020]; 15(37):589-99. Available from: https://doi.org/10.1590/S1414-32832011000200021
Øien-Ødegaard C, Reneflot A, Hauge Lj. Use of primary healthcare services prior to suicide in Norway: a descriptive comparison of immigrants and the majority population. BMC Health Serv Res. [Internet]. 2019 [cited 11 jan 2020]; 19(1):508. Available from: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4246-3
de Linhares LMS, Kawakame PMG, Tsuha DH, de Souza AS, Barbieri AR. Construction and validation of an instrument for the assessment of care provided to people with suicidal behavior. Rev Saude Publica [Internet]. 2019; [cited 11 jan 2020]; 6(53):48. Available from: https://doi.org/10.11606/S1518-8787.2019053000888
Williamson MLC, Hogue G, Cotter J, Roberman S, Neal G, Williamson B. Suicide screening: How to recognize and treat at-risk adults. J Fam Pract. [Internet]. 2019 [cited 11 jan 2020]; 68(9):505-510. Available from: https://pubmed.ncbi.nlm.nih.gov/31725135/
Denneson LM, Trevino AY, Kenyon EA, Ono SS, Pfeiffer PN, Dobscha SK. Health Coaching to Enhance Psychological Well-being Among Veterans with Suicidal Ideation: a Pilot Study. J Gen Intern Med. [Internet]. 2019 [cited 22 fev 2020]; 34(2):192-194. Available from: https://link.springer.com/article/10.1007/s11606-018-4677-2
Jerant A, Duberstein P, Cipri C, Bullard B, Stone D, Paterniti D. Stakeholder views regarding a planned primary care office-based interactive multimedia suicide prevention tool. Patient Educ Couns. [Internet]. 2019 [cited 22 fev 2020]; 102(2):332-339. Available from: https://doi.org/10.1016/j.pec.2018.09.007
Ferrin SN, Shan M, Garbuz T, Aalsma MC. 136. Suicide Screening And Intervention Among Adolescents In The Primary Care Setting. J Adolesc Heal. [Internet]. 2019 [cited 22 fev 2020]; 64(2): S70–71. Available from: https://doi.org/10.1016/j.jadohealth.2018.10.152
Trout L, McEachern D, Mullany A, White L, Wexler L. Decoloniality as a Framework for Indigenous Youth Suicide Prevention Pedagogy: Promoting Community Conversations About Research to End Suicide. Am J Community Psychol. [Internet]. 2018 [cited 30 jun 2020]; 62(3-4):396-405. Available from: https://doi.org/10.1002/ajcp.12293
Bhat S, Kroehl ME, Trinkley KE, Chow Z, Heath LJ, Billups SJ, et al. Evaluation of a Clinical Pharmacist-Led Multidisciplinary Antidepressant Telemonitoring Service in the Primary Care Setting. Popul Health Manag. [Internet]. 2018 [cited 30 jun 2020]; 21(5):366-372. Available from: https://doi.org/10.1089/pop.2017.0144
Storino BD, Campos CF e, Chicata LC de O, Campos M de A, Matos MS da C, Nunes RMCM et al. Atitudes de profissionais da saúde em relação ao comportamento suicida. Cad Saúde Coletiva. [Internet]. 2018 [cited 22 fev 2020]; 26(4):369-377. Available from: https://doi.org/10.1590/1414-462X201800040191
Ribeiro MMR, Tavares R, Melo EM, Bonolo PF, Melo VH. Promoção de saúde, participação em ações coletivas e situação de violência entre usuários da Atenção Primária à Saúde. Saúde debate. [Internet]. 2018 [cited 30 jun 2020];42(spe4):43-54. Available from: https://doi.org/10.1590/0103-11042018S403
de Freitas Silva P, de Sousa Nóbrega MPS, de Oliveira E. Knowledge of the Nursing Team and Community Agents on Suicide Behavior. J Nurs UFPE. [Internet]. 2018; [cited 22 fev 2020]; 12(1):112–117. Available from: https://doi.org/10.5205/1981-8963-v12i1a23511p112-117-2018
Etter DJ, McCord A, Ouyang F, Gilbert AL, Williams RL, Hall JA, et al. Suicide Screening in Primary Care: Use of an Electronic Screener to Assess Suicidality and Improve Provider Follow-Up for Adolescents. J Adolesc Heal. [Internet]. 2018 [cited 22 fev 2020]; 62(2):191-197. Available from: https://doi.org/10.1016/j.jadohealth.2017.08.026
Vannoy S, Park M, Maroney MR, Unützer J, Apesoa-Varano EC, Hinton L. The Perspective of Older Men with Depression on Suicide and Its Prevention in Primary Care: Implications for Primary Care Engagement Strategies. Crisis. [Internet]. 2018 [cited 25 fev 2020]; 39(5):397-405. Available from: https://doi.org/10.1027/0227-5910/a000511
da Silva, NKN; de Carvalho, CMS; Magalhães, JM, de Carvalho Junior, JAM, Sousa BVS, Moreira WC. Nursing actions in primary care to prevent suicide. Revista Eletrônica Saúde Mental Álcool e Drogas. [Internet]. 2018 [cited 25 fev 2020]; 13(2):71-77. Available from: http://dx.doi.org/10.11606/issn.1806-6976.v13i2p71-77
Dueweke AR, Rojas SM, Anastasia EA, Bridges AJ. Can brief behavioral health interventions reduce suicidal and self-harm ideation in primary care patients? Fam Syst Heal. [Internet]. 2017 [cited 22 fev 2020];35(3):376-381. Available from: https://doi.org/10.1037/fsh0000287
Diamond GS, Herres JL, Krauthamer Ewing ES, Atte TO, Scott SW, Wintersteen MB, et al. Comprehensive Screening for Suicide Risk in Primary Care. Am J Prev Med. [Internet]. 2017 [cited 06 jul 2020];53(1):48-54. Available from: https://doi.org/10.1016/j.amepre.2017.02.020
Bantjes J. ‘Don’t push me aside, Doctor’: Suicide attempters talk about their support needs, service delivery and suicide prevention in South Africa. Health Psychol Open. [Internet]. 2017 [cited 06 jul 2020];4(2):2055102917726202. Available from: https://doi.org/10.1177/2055102917726202
Meyer D, Abbott JA, Rehm I, Bhar S, Barak A, Deng G, et al. Development of a Suicidal Ideation Detection Tool for Primary Healthcare Settings: Using Open Access Online Psychosocial Data. Telemed e-Health. [Internet]. 2017 [cited 06 jul 2020];23(4):273-281. Available from: https://doi.org/10.1089/tmj.2016.0110
Iorfino F, Davenport TA, Ospina-Pinillos L, Hermens DF, Cross S, Burns J, et al. Using new and emerging technologies to identify and respond to suicidality among help-seeking young people: A cross-sectional study. J Med Internet Res. [Internet]. 2017 [cited 06 jul 2020];19(7):1-14. Available from: https://doi.org/10.2196/jmir.7897
Leavey G, Mallon S, Rondon-Sulbaran J, Galway K, Rosato M, Hughes L. The failure of suicide prevention in primary care: Family and GP perspectives - a qualitative study. BMC Psychiatry. [Internet]. 2017 [cited 06 jul 2020];17(1):1–10. Available from: https://doi.org/10.1186/s12888-017-1508-7
LeCloux M, Maramaldi P, Thomas KA, Maramaldi P, Thomas KA, Wharff EA. A Longitudinal Study of Health Care Resources, Family Support, and Mental Health Outcomes Among Suicidal Adolescents. Anal Soc Issues Public Policy. [Internet]. 2017 [cited 06 jul 2020];17(1):319-38. Available from: https://doi.org/10.1111/asap.12139
Etter DJ, Ouyang F, Gilbert AL, Williams RL, Hall JA, Tu W, et al. Use of an Electronic Screener to Assess Adolescent Suicide Risk and Provider Follow-Up in a Primary Care Setting. J Adolesc Health. [Internet]. 2017 [cited 08 jul 2020];60(2):S93-94. Available from: https://doi.org/10.1016/j.jadohealth.2016.10.365
Windfuhr K, While D, Kapur N, Ashcroft DM, Kontopantelis E, Carr MJ, et al. Suicide risk linked with clinical consultation frequency, psychiatric diagnoses and psychotropic medication prescribing in a national study of primary-care patients. Psychol Med. [Internet]. 2016 [cited 08 jul 2020];46(16):3407–3417. Available from: https://doi.org/10.1017/S0033291716001823
Saini P, Chantler K, Kapur N. General practitioners’ perspectives on primary care consultations for suicidal patients. Heal Soc Care Community. [Internet]. 2016 [cited 08 jul 2020];24(3):260–269. Available from: https://doi.org/10.1111/hsc.12198
Denneson LM, Williams HB, Kaplan MS, McFarland BH, Dobscha SK. Treatment of veterans with mental health symptoms in VA primary care prior to suicide. Gen Hosp Psychiatry. [Internet]. 2016 [cited 08 jul 2020];38:65-70. Available from: https://doi.org/10.1016/j.genhosppsych.2015.08.007
Michail M, Tait L. Exploring general practitioners’ views and experiences on suicide risk assessment and management of young people in primary care: A qualitative study in the UK. BMJ Open. [Internet]. 2016 [cited 08 jan 2021];6(1):e009654. Available from: http://dx.doi.org/10.1136/bmjopen-2015-009654
Malakouti SK, Nojomi M, Ahmadkhaniha HR, Hosseini M, Fallah MY, Khoshalani MM. Integration of suicide prevention program into primary health care network: A field clinical trial in Iran. Med J Islam Repub Iran. [Internet]. 2015 [cited 08 jan 2021];29208. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476228/
Younes N, Melchior M, Turbelin C, Blanchon T, Hanslik T, Chee CC. Attempted and completed suicide in primary care: Not what we expected? J Affect Disord. [Internet]. 2015 [cited 08 jan 2021];170:150-154. Available from: http://dx.doi.org/10.1016/j.jad.2014.08.037
Malakouti SK, Nojomi M, Poshtmashadi M, Shooshtari MH, Moghadam FM, Rahimi-Movaghar A, et al. Integrating a Suicide Prevention Program into the Primary Health Care Network: A Field Trial Study in Iran. [Internet]. 2015 [cited 08 jan 2021];2015:193729. Available from: https://doi.org/10.1155/2015/193729
Obando Medina C, Kullgren G, Dahlblom K. A qualitative study on primary health care professionals’ perceptions of mental health, suicidal problems and help-seeking among young people in Nicaragua. BMC Fam Pract. [Internet]. 2014 [cited 08 jan 2021];15(1):1-8. Available from: https://doi.org/10.1186/1471-2296-15-129
Shah R, Franks P, Jerant A, Feldman M, Duberstein P, Y Garcia EF, et al. The effect of targeted and tailored patient depression engagement interventions on patient-physician discussion of suicidal thoughts: A randomized control trial. J Gen Intern Med. [Internet]. 2014 [cited 08 jan 2021];29(8):1148–1154. Available from: https://doi.org/10.1007/s11606-014-2843-8
Santos JC, Simões RMP, De Azevedo Erse MPQ, Façanha JDN, Marques LAFA. Impact of “+contigo” training on the knowledge and attitudes of health care professionals about suicide. Rev Lat Am Enfermagem. [Internet]. 2014 [cited 08 jan 2021];22(4):679-684. Available from: https://doi.org/10.1590/0104-1169.3503.2467
Dobscha SK, Denneson LM, Kovas AE, Corson K, Helmer DA, Bair MJ. Primary care clinician responses to positive suicidal ideation risk assessments in veterans of Iraq and Afghanistan. Gen Hosp Psychiatry. [Internet]. 2014 [cited 08 jan 2021];36(3):310–317. Available from: http://dx.doi.org/10.1016/j.genhosppsych.2013.11.007
Galimbertti PA, Bógus lMM. Incerteza, angústia e culpa na pós-modernidade: uma reflexão sobre a morte voluntária, na sociedade célere e disforme do século XXI. In: Albuquerque IMN, Galimbertti PA (organizadores). Sociopolítica da saúde: a importância do SUS em época de instabilidade. Sobral, 2021. p. 41-75. Available from: http://www.uvanet.br/edicoes_uva/gera_xml.php?arquivo=sociopolitica_saude
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